HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \3\\2�a Permit Number:
RECEIVED
Building Permit Applicat on JAN 31 2020
Planning and Development Services
Building and Code Regulation Division ST.Lucie County,Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PROPOSED 1 PROUEMrfNT LOCATION:
Address: �e� /S �I �' f707- '!:F¢12 15LOJ 3 ww
Property Tax ID#: \� \\ -�\�S a� \tee 6o4—y Lot No.
Site Plan Name: Block No.
Project Name: �'b /,-'AM- Pe ¢,VgC
DETA(LED DE�aCR�tPTION OF WORK:
�ONSTOUCTION I�NFORMA ION:
Additional work to be performed under this permit-check all that apply:
—Mechanical _Gas Tank —Gas Piping_ Shutters _Windows/Doors
t//Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer Septic Building Height:
OWNER/LESSEE CONTRA TO
Name V
r a rD A,,,> Name:
Address: ^i 0�'/Z 44o 4 Company:
City: r!? State: f-1 Address: T673 S" 6e,��,t PQ) *is
Zip Code: 3 4f f 4!f Fax: City: 11,13 State:—/---(-
Phone No. Zip Code: 3a54 (o Fax:
E-Mail: V ��r� �[. 4sw`. Phone No 5&.--604W
Fill in fee simple Title Holder on next page(if different E-Mail SSE(� �d✓2lyGGG �
from the Owner listed above) State or County License e!5�/3,0 tea s-srs-
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SIJPPLENl,EN�'RL Ct!?'NSTI�+IICTI�N ��N LA IiNFO .MAT 0
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:• Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit•to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws.or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and'review your deed for any restrictions which may'apply.
In consideration of the granting of this requested permit, I do hereby agree that-1 will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAIL ECORD A NOTICE OF COMMENCEMENT MAY RESULT IN PAYING
TWICE FOR 1 YEMENTS O YOUR OPERTY. A NOTICE OF ENCEMENT MUST RECOR ED AND
POSTED O T JOB SITEflliFORE TH FIRST INSPECTION. IF Y TEND TO OBTAIN FI ANCING ONSULT
WITH R DER OR ANTTORNE EF DING TICE OF COMMENCEM T., ---
i nat wrier/Lessee/Contractor as A nt for Owner ignatur Contractor/License Holder
STATE OF FLORg) L� c STATE OF FLORIA
COUNTY OF COUNTY OF
The forgoing instrument was acknowled ed before me The for oing instr�.ment was acknowledged before me
this3� day of Scn J� 208 by this day of J q 20 dd by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced *V—L_ L Produced
(Signature of Notary Public-State of Florida) g komm,
Signatur .f .4_ orizq
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